One really good thing I can say about the boy’s pediatrician is that they get you in to an appointment rather quickly. We had a doctor appointment the day after the Young 5’s teacher reported the boy’s strange behavior to us. The pediatrician told us to discontinue the guanfacine and also said that he needed to refer us to a psychiatrist for further treatment of the boy’s ADHD. (After 4 unsuccessful medications, I think he had exhausted his expertise.) That night I called our insurance carrier and was told that only one place in our area was covered by our insurance. The very next day I was at the community mental health doing the intake process. I had to take the kids with me and, oh.my.gosh. did the boy act out for the poor intake worker! She got to see first hand the types of behaviors mommy gets to deal with! I was told that in order to even make an appointment with a psychiatrist, we had to first meet with a behavioral specialist at our home, and she had to draw up a behavior plan for the boy, submit it, get it approved, and then we could make an appointment (usually scheduled about 6 weeks out). Sure, take your time. The boy’s back on his focalin, which isn’t working any longer, the teacher’s having “rough days” almost daily… no problem. And the pediatrician has, in a way, washed his hands of us.
I sent the boy to school completely unmedicated (except for a dose of a homeopathic “calm restore” and some fish oil), the teacher called after school and said that he was back to doing cartwheels on the rug during rug time and accidently knocking chairs over & all the old habits that got us started on this ADHD medication in the first place. After a lengthy conversation, we decided that the first medication was the best of all the ones we’ve tried (even though it stopped working after several weeks.) I sent him to school on medidate 10mg. I didn’t know what to do. Two days later the teacher called and said it wasn’t helping matters at all.
I called the pediatrician and the first thing they said was, “I thought I referred you out to a psychiatrist for further treatment.” After explaining the lengthy process required to even schedule an appointment, and expressing that we needed help NOW, they told me they would refer the message to the doctor. That evening the doctor’s office called back and suggested a drug called Vyvanse. They explained that Vyvanse was not available in a generic form and was very expensive, but that they had heard good things about it. I researched it on line, and called our insurance to see if it was covered, and the next day pediatrician sent in the paperwork to get the new medication approved by our insurance company. Three days later, we picked up our new prescription.
The boy started Vyvanse 20mg (lowest dose) on a Wednesday, so the teacher didn’t get too much time to observe the effects of the new medication. The next Monday she called and told me that they had been having “real rough days” again, and that it had gotten so bad that he was spending more time outside of the classroom then inside, due to him removing himself from the stimulation or her having to remove him. And if he was this difficult on Tuesday, they’d have to send him home. I called the doctor and he suggested to raise the Vyvanse to 30mg. Tuesday I had a meeting at the boy’s school (to sign paperwork for the Positive Behavioral Assessment I had requested because none of our medications had been successful yet.–Each state is different, so I won’t link to a specific site.) We hadn’t gotten the new script in time for the boy to take the higher dose for school, so he was still on the 20mg. As I was walking out after the meeting, the teacher’s assistant happened to be in the hallway escorting a child to the water fountain, she saw me and waved me over. She said that they had been trying to call me and didn’t know I was in the building. The boy was a sobbing mess when I saw him. They told me that he wanted to be with me and kept telling them that I was at school (they didn’t know I was there, so they thought he was just saying weird random stuff.) He clung to me and cried when I said he needed to stay in school. I couldn’t understand all of what he was saying, but I did hear him say at one point, “there’s something wrong.” The teachers said they thought that he was thinking that there was something wrong with me, and had to be reassured that I was ok. But there was no calming him, and I ended up bringing him home with me.